COVER STORY

Only a few months re­main un­til vol­un­tary par­tic­i­pa­tion in CDC’s re­port­ing net­work be­gins, and Medi­care dol­lars are on the line

Par­tic­i­pa­tion in the CDC’s Na­tional Health­care Safety Net­work is vol­un­tary, but hos­pi­tals must be on­board by Jan­uary 2011 for cen­tral line-as­so­ci­ated blood­stream in­fec­tions, or they risk Medi­care pay­ment penal­ties. A sim­i­lar re­quire­ment is in place for sur­gi­cal-site in­fec­tions start­ing in 2012. “We’re very pleased with the an­nounce­ment,” re­gard­ing the two mea­sures, said Rus­sell Olm­sted, pres­i­dent-elect of APIC.

The CMS has raised the bar for re­port­ing health­care-as­so­ci­ated in­fec­tions by ty­ing hos­pi­tals’ an­nual pay­ment update to sub­mis­sion of in­fec­tion data via the Cen­ters for Dis­ease Con­trol and Pre­ven­tion’s se­cure, Web-based sur­veil­lance sys­tem.

Be­gin­ning next year, the agency is re­quir­ing that hos­pi­tals use the CDC’s Na­tional Health­care Safety Net­work, or NHSN, to re­port their in­ci­dences of cen­tral line-as­so­ci­ated blood­stream in­fec­tions, in or­der to re­ceive a full Medi­care pay­ment update for 2013. In ad­di­tion, hos­pi­tals will need to re­port on sur­gi­cal­site in­fec­tions be­gin­ning in Jan­uary 2012 to re­ceive full re­im­burse­ment for 2014.

The NHSN has been widely praised for its use of set def­i­ni­tions and pro­to­cols, and the move is ex­pected to in­tro­duce much-needed stan­dard­iza­tion to na­tional re­port­ing of health­care-as­so­ci­ated in­fec­tions, at least for those two mea­sures.

“We’re very pleased with the an­nounce­ment,” said Rus­sell Olm­sted, pres­i­dent-elect of the As­so­ci­a­tion for Pro­fes­sion­als in In­fec­tion Con­trol and Epi­demi­ol­ogy, and an epi­demi­ol­o­gist at St. Joseph Mercy Health Sys­tem, Ann Ar­bor, Mich. “Us­ing one sin­gle plat­form with stan­dard def­i­ni­tions helps en­sure that the method of eval­u­at­ing in­fec­tions in San Diego is the same as it is in Boise. It cre- ates a level play­ing field.”

The mea­sures were in­cluded in the CMS’ fi­nal re­vi­sions to the in­pa­tient prospec­tive pay­ment sys­tem, or IPPS, is­sued July 30, and are part of the Re­port­ing Hos­pi­tal Qual­ity Data for An­nual Pay­ment Update pro­gram. In the fi­nal rule, the CMS left the door open to in­clude other types of in­fec­tions for fu­ture NHSN re­port­ing, in­clud­ing ven­ti­la­tor-as­so­ci­ated pneu­mo­nia and mul­tidrug-re­sis­tant or­gan­ism in­fec­tions.

En­roll­ment in the NHSN is free, but it does re­quire time and pa­tience, ac­cord­ing to in­fec­tion pre­ven­tion­ists. Fa­cil­i­ties must agree to use the net­work’s tools and in­ter­faces, ad­here to set method­olo­gies and re­port re­sults pe­ri­od­i­cally. They must also ful­fill a num­ber of train­ing re­quire­ments. The CDC’s NHSN web­site fea­tures in­struc­tional we­b­cast ses­sions cov­er­ing en­roll­ment, data en­try, sur­veil­lance, pa­tient safety and health­care per­son­nel safety. For in­stance, all NHSN users are re­quired to re­ceive cen­tral-line-in­ser­tion prac­tices train­ing, which

In Jan­uary 2012, hos­pi­tals will be re­quired to re­port sur­gi­cal-site in­fec­tions or face a Medi­care pay­ment penalty in 2014. A sim­i­lar re­quire­ment for cen­tral line-as­so­ci­ated blood­stream in­fec­tions be­gins next year.